Browsing Tag

Obstetrics & Gynecology

General Information, Microbiology, Test Utilization

Discontinuation of Placenta Microbiology Cultures

As of April 12, 2022, Spectrum Health Laboratory will no longer add microbiology cultures to placental tissues received based on paper requisition forms.

Viral and bacterial cultures from placental tissue are rarely clinically beneficial and are no longer the gold standard diagnostic approach due to the relative insensitivity of culture methods.

If viral studies are desired (possible indications could include known CMV exposure with positive IgM or intrauterine fetal demise at < 28 weeks), then molecular testing is the recommended diagnostic approach. HSV and CMV PCR tests may be ordered in Epic.

Herpes Simplex 1/2 Qualitative PCR, Tissue (LAB1230413)

Cytomegalovirus (CMV) Qualitative PCR, Tissue (LAB1230291)

Bacterial cultures are challenging to interpret since they typically grow normal genital flora and histopathological analysis used to diagnose acute chorioamnionitis correlates poorly with growth from bacterial placenta cultures. If indicated, culture and PCR tests may be ordered in Epic.

Tissue Culture (LAB2111173)

Metamycoplasma hominis, Molecular Detection, PCR, Varies (LAB848)

Ureaplasma species, Molecular Detection, PCR, Varies (LAB848)

Placenta tissues sent to the lab in formalin are not acceptable for PCR or culture orders.

Advanced Technology Laboratory, Molecular Diagnostics

Test Discontinuation: MTHFR C677T

MTHFR C677T [LAB7390], the methylenetetrahydrofolate reductase mutation analysis, is being discontinued as an obsolete test.

The American College of Medical Genetics (ACMG) and American College of Obstetricians and Gynecologists (ACOG) have determined that MTHFR C677T testing has minimal clinical utility. Current testing recommendations indicate that this test should not be ordered as part of a routine evaluation for thrombophilia or adverse pregnancy outcomes. Continue Reading

Chemistry, General Information, Immunochemistry

Test Update: Rubella IgG Antibody Testing

On January 24th, 2022 Rubella Antibody, IgG, Serum (LAB496) and Rubella IgG Antibody Quantitative (LAB3544) will be combined as LAB496 and moved to the Immunochemistry laboratory due to reagent constrains with the current vendor.

Testing will be available Monday-Friday with a turn-around-time of 1-3 days. Results will be reported qualitatively as Immune or Not Immune.  If quantitative results are needed, please fax Immunochemistry at 616-267-2771 or call 616-267-2770. Continue Reading

Molecular Diagnostics

Cystic Fibrosis (CF) Carrier Screen Discontinued

Effective February 1, 2022, the Cystic Fibrosis (CF) Carrier Screen test, which includes the 23 common variants for cystic fibrosis recommended by ACOG/ACMG, will be discontinued as an orderable test at Spectrum Health Laboratory.

The recommended replacement test is the Cystic Fibrosis Mutation Analysis (Test ID: CFP) offered by Mayo Clinic Laboratories, a 106-variant panel which includes the recommended 23 common variants.

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Microbiology, Test Spotlight

Influenza Testing Recommendation Update (December 2021)

The mitigation strategies enacted during the COVID-19 pandemic to reduce the spread of this virus led to essentially non-existent influenza prevalence during the 2020-2021 winter season. However, influenza has now returned and case numbers are increasing throughout West Michigan.

Influenza prevalence guides the most appropriate testing approach and sufficient prevalence has now been reached for influenza rapid antigen testing (e.g. Sofia instrument) to have improved performance. The use of rapid antigen testing as a screening method during high prevalence reduces both the cost to the patient and turn-around-time as compared to lab-based molecular methods. Rapid antigen tests generally have high analytical specificity, but lack the sensitivity of nucleic acid amplification methods (e.g. PCR). For this reason, PCR testing is still recommended for hospitalized patients and for outpatients with a negative antigen result if influenza is still suspected and if the result will impact clinical decision making. Continue Reading

Main lab, Microbiology, Test Utilization

Influenza Testing Reminder

The mitigation strategies enacted during the COVID-19 pandemic to reduce the spread of this virus have also impacted the transmission of other respiratory viruses. Influenza is typically prevalent during the winter months (December through March), however, influenza cases were essentially non-existent during the 2020-2021 season and influenza is not currently circulating in our community.

In the absence of circulating influenza activity, it is recommended to use the most sensitive diagnostic test in order to obtain accurate and actionable results. Influenza antigen testing (e.g. Sofia instrument) is not appropriate at this time. More detailed information can be found as published by the CDC: Algorithm to assist in the interpretation of influenza testing results and clinical decision-making during periods when influenza viruses are NOT circulating in the community

Low Influenza
prevalence
High influenza
prevalence
Recommended order Influenza PCR (LAB3255) Influenza Rapid Antigen (LAB2111530)
or
Influenza PCR (LAB3255)

TEST INFORMATION

Test name Epic code Interface EMR Code CPT Code
 Influenza PCR  LAB3255 11594 87502
 Influenza Rapid Antigen  LAB2111530 11208 87804 x4
Advanced Technology Laboratory, General Information, Main lab

Update: COVID-19 Swab Supplies

If you are collecting COVID-19 swabs in your office or clinic, please order and collect using the saline swab kits (“liquid media” or “wet collection”) instead of the tube with no liquid media (“dry collection”).

• Liquid media swab kits will provide a faster turn-around time.

• Dry collection kits supplies are low.

Please refer to the COVID-19 PCR test in the Lab Catalog for the most up-to-date information on COVID-19 collection.

COVID-19 PCR Swab – LAB1230607

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Compliance & Safety, Education & Training, General Information

Self-Collected Swabs

Self-collected vaginal swabs may be used for testing as opposed to provider-collected swabs. Self-collected swabs are supported by current clinical guidelines as recent studies have shown their equivalence, if not superiority, in quality and their association with increased patient satisfaction.

NOTE: Self-collection must still take place in a healthcare setting and is not approved for at-home collection.

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Main lab, Microbiology

Test Update: Group B Streptococcus PCR Shortage

Test manufacturer supply chains continue to be disrupted due to COVID-19. Currently, there is a shortage of supplies for the Group B Streptococcus PCR test. Orders for this PCR test may continue to be placed, however, the SHRL Microbiology Department will perform a culture method until PCR supplies are available with appropriate charging and a reporting comment indicating that the culture was performed. The PCR test is normally resulted within 24-48 hours of specimen receipt in lab, whereas the culture method turnaround time may be 48-72 hours. An update will be posted when these PCR supplies are received, however, there may continue to be intermittent supply issues for this test. Additional test information can be found here.